Delayed respiratory arrest after bupivacaine

Holmboe, Jørgen; Kongsrud, F.

doi:10.1111/j.1365-2044.1982.tb00996.x

Cited by 9 publications

(1 citation statement)

References 6 publications

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“…It may also be caused by motor block following high spinal or extradural blocks; it may occur as a focal effect following retrobulbar block in ophthalmic surgery (Smith, 1982;Hathaway, 1983) or from possible subarachnoid spread following an excessive dose by interscalene brachial plexus block (Lauckner, 1982). Delayed respiratory arrest has been reported 3 h after uneventful extradural administration, as a quasi side effect of bupivacaine (Holmboe and Kongsrud, 1982), but as the patient was fully conscious but totally paralysed, subdural extra-arachnoid spread, which commonly produces a delayed but extensive effect, is a more likely explanation. An increase in extradural pressure may cause transient respiratory depression (Gissen and Leith, 1985).…”

Section: Table II Toxidty Data (Mg Kg-1 or Mg Litre-') * The Uk Dmentioning

confidence: 99%

Adverse Effects of Local Anaesthetics

Reynolds¹

1987

British Journal of Anaesthesia

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Complications of local anaesthesia in general have been considered in so far as they may be confused with adverse effects of local anaesthetic drugs. Local anaesthetics may give rise to adverse reactions by a number of mechanisms. They affect nerve conduction and vasculature at the site of injection: a local effect; but is it unlikely that they ever produce an irreversible noxious effect on nerve fibres. They produce regional effects resulting from nerve conduction blockade; hypotension and respiratory depression by this mechanism are frequently mistaken for pharmacological effects of the agent concerned. They produce focal effects, usually when carried in high concentration via the arterial supply to the brain. They produce systemic effects following absorption or intravenous administration, which are manifested principally in the central nervous system. Ignorance or carelessness are frequently causative factors in serious reactions. Adequate oxygenation is vital in prophylaxis and immediate treatment of systemic toxicity, while resuscitative skill and equipment must always be to hand. Idiosyncrasy or allergy can only rarely be an excuse for adverse reactions to local anaesthesia.

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Section: Table II Toxidty Data (Mg Kg-1 or Mg Litre-') * The Uk Dmentioning

confidence: 99%